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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �j � ZS`v � <br /> 425-257-E810 - FAX 425-257-8857 —www.everettwa.org �go 6_,� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> `0�.52� E. G�o�,nGf �� <br /> PROJECT ADDRESS <br /> �L�x �1-ho 1-�- <br /> Owner Mail Addross City State2lp Phone <br /> Tenant Mail Address Cily StateZp Phone <br /> S��1 N�-�c-� le�, . i lA 2 S Waqu�r �� Mo n �� Wi4 �Z7L u2s�z.3L-88� <br /> Eledrical Confraclor Mail Address City State/Zip Phone <br /> Senn�c.a�o��- <br /> Slate License Number Contract Price of Work <br /> Proposed Use ot 9uilding ;'ontad Person (Plan Review) <br /> Descriplion of Work lo Be Dono: �='•f�\CL ��1 SPCc TiDr� �/��i /`�1 <br /> �- '-f-/ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily(ha(1 have read and examined this application and know fhe seme to be frue and <br /> correct. All provisions o(laws and ordinances govem(ng this type o(work will be completed <br /> whefher specifiod herein or noL The granfing of a permd does nof presume to give aufhonty to <br /> viulafe or cancel fhe provisions of any ofher state or local law regulating construction or the <br /> perfomiance ol construcfion. That I am aufhonzed by fhe owner o/fhis property fo pedorm the <br /> work lor whisl�application is mado and 1 comply wifh the Stafe Confrnctors Law 18.27 RCW and <br /> 296.20Q W?G. <br /> ���U/�- >� �- 25, o� <br /> SignaWra Date <br /> �=a��-1 3 I <br />